Prostate Cancer in Australia 2025: What Every Man Needs to Know About Risks, Early Detection, and the Latest Treatments

Prostate cancer is the most commonly diagnosed cancer among Australian men in 2025, with thousands of new cases each year. This article provides essential insights into understanding prostate cancer, including the risks, symptoms, early detection methods, and the latest treatment options to help men make informed decisions about their health and well-being.

Understanding Prostate Cancer: Who Is at Risk?

Prostate cancer develops when cells in the prostate gland grow uncontrollably, forming a malignant tumour. It primarily affects men over the age of 50, with the average age of diagnosis at 70. By age 85, one in six Australian men will be diagnosed.

Key risk factors:

Age: Risk rises sharply after 50.
Family history: A father or brother diagnosed before 60, or family history of prostate, breast, or ovarian cancer (especially with BRCA1 or BRCA2 mutations), increases risk.
Testosterone levels: High testosterone exposure may be linked, though further research is ongoing.
Other factors: Evidence for lifestyle changes or screening measures that reliably prevent prostate cancer remains unconfirmed.

Recognising the Symptoms

Early (localised) prostate cancer typically does not cause noticeable symptoms, which is why many cases are identified through tests rather than symptoms.

Symptoms of more advanced prostate cancer may include:

Frequent, urgent, or painful urination
Blood in urine or semen
Weak urine stream
Persistent pain in the lower back, pelvis, or hips
Weakness in the legs or feet, particularly if cancer has advanced
Bone pain
Unexplained weight loss and fatigue

Given that early-stage prostate cancer often develops without symptoms, it is important for men over 50 or those with a family history to engage with healthcare providers regarding health assessments.

Early Detection and Diagnosis

There is currently no Australian population screening program for prostate cancer. The decision to undergo testing should follow a discussion with a doctor, considering individual risks and circumstances.

Main diagnostic tools include:

PSA (Prostate-Specific Antigen) blood test: Measures a protein produced by prostate cells. PSA results can be influenced by several factors and are not cancer-specific; not all men with elevated PSA have cancer, and some with cancer may have normal PSA levels.
Digital Rectal Examination (DRE): Not routinely recommended for asymptomatic men, but may be performed if there are clinical indications.
Biopsy with imaging (mpMRI): Used to confirm diagnosis and assess cancer aggressiveness (using the Gleason score).
Scans (MRI, CT, bone): Used to evaluate possible spread beyond the prostate.

Consult your doctor to understand the potential benefits and limitations of PSA and other tests to support an informed decision.

Treatment Options in 2025

Treatment for prostate cancer in Australia is individualised based on:

The cancer’s stage and grade (aggressiveness)
Patient’s age, general health, and preferences

Main treatment options include:

1. Active Surveillance

Who it’s for: Low-risk, localised (early-stage) cancer not causing symptoms (“PSA <10, Gleason 6 or less”).
What it involves: Regular PSA tests, MRI scans, and biopsies; treatment is initiated if the cancer appears to progress.
Why: Reduces risk of overtreatment and related side effects. In Australia, many with low-risk prostate cancer choose this approach.

2. Watchful Waiting

Who it’s for: Typically recommended for older men, those with significant health concerns, or with advanced cancer not expected to impact life expectancy.
What it involves: Less intensive monitoring and a focus on managing symptoms if and when they develop.

3. Surgery (Radical Prostatectomy)

What it is: Surgical removal of the prostate (sometimes with neighbouring tissue or lymph nodes).
How: Can be performed via open, laparoscopic, or robot-assisted methods.
Potential side effects: Erectile dysfunction, urinary incontinence, infertility, “dry” orgasm, and possible changes in penis length.

4. Radiation Therapy

Types:
- External Beam Radiation Therapy (EBRT)
- Brachytherapy (internal radioactive implant)
When used: Can be a primary treatment, or used before or after surgery.
Potential side effects: Fatigue, changes in urinary or bowel function, erectile dysfunction, infertility, and, in some cases, later bladder or bowel issues.

5. Androgen Deprivation Therapy (ADT)

What it is: Hormone therapy to decrease testosterone, which may slow cancer growth.
How: Treatments include injections, tablets, or (less commonly) surgical removal of the testicles.
When used: Often combined with radiation or as treatment for advanced cancer.
Potential side effects: Hot flushes, reduced libido, bone thinning, fatigue, and changes in mood and physical health.

6. Chemotherapy and New Drug Therapies

When used: For advanced or metastatic cancer that does not respond to hormone therapy.
Medications: Options include abiraterone, enzalutamide, olaparib (used in specific genetic contexts), among others—many are now subsidised in Australia.
Potential side effects: Fatigue, increased risk of infection, hair loss, neuropathy, and other effects commonly associated with chemotherapy.

Focal therapies (such as ablation) are under investigation and currently available primarily through clinical trials.

Managing Side Effects

Side effects from surgery, radiation, hormone therapy, and chemotherapy can affect quality of life. Early and ongoing consultation with healthcare professionals—including continence specialists, physiotherapists, and sexual health advisors—may assist in managing complications such as:

Erectile dysfunction
Urinary incontinence
Emotional and psychological distress

Discuss fertility preservation options, such as sperm banking, prior to starting treatment if future fertility is a consideration.

Palliative and Ongoing Care

For men with advanced or incurable prostate cancer, palliative care is available to help manage pain, control symptoms, and provide emotional support. Specialist teams can offer advice on medications, counselling, and allied health services.

Prostate Cancer Support and Awareness

Receiving a prostate cancer diagnosis can be challenging. Various Australian organisations offer professional, peer, and informational support:

Cancer Council: Call 13 11 20 for confidential information and assistance.
Prostate Cancer Foundation of Australia (PCFA): 1800 22 00 99 or prostate.org.au – providing specialist nurses, support groups, and educational resources.

Awareness initiatives, especially during Men’s Health Week, encourage men to discuss health checks and prioritise mental wellbeing.

Current Research and Developments

Australia is active in prostate cancer research, with ongoing studies and advancements in several areas:

Exercise as therapy: Studies suggest that tailored physical activity can support treatment and mitigate some side effects.
New drug therapies: Recent advances in hormonal and targeted treatments—including therapies for individuals with specific gene mutations—have become standard for certain advanced cases.
Triple therapy trials: The combination of hormone therapy, chemotherapy, and hormone blockers is currently being trialled.
Less invasive and focal therapies: These remain in the investigational stage and may become more available as evidence grows.

Participation in clinical trials may provide access to emerging therapies; discuss options with your healthcare provider.

Approaches to Prostate Cancer Prevention

There are currently no confirmed strategies to reliably prevent prostate cancer. Maintaining a healthy lifestyle, being aware of personal risk factors, and regularly consulting with your healthcare professional are currently recommended. Early detection and appropriate treatment contribute to positive outcomes, especially if the cancer is identified in its localised stage.

Final Thoughts

Prostate cancer is treatable, particularly when identified early. Men over 50, or those with a family history, are encouraged to consult their healthcare provider to discuss risk and screening. Ongoing research, developments in treatment, and comprehensive support networks mean individuals affected by prostate cancer in Australia have access to quality information and care.

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